It it a Cold, Sinus Infection, or Allergy?

In Arizona, one of the challenges patients and physicians face during February and March is determining if that runny nose, scratchy throat, and sinus pain is the beginning of the spring allergy season, a late winter cold, or worse.  Here are a few clues to help sort it out.

  1. Allergy itches.  Most seasonal allergy attacks involve itching, either of the eyes, the nose, the throat, or skin.  When an allergic reaction occurs, histamine is released into the tissues causing redness, swelling, and itching.  Histamine is also released during a viral cold (which is why antihistamines are frequently prescribed for a cold) but this is not the primary chemical mediator causing symptoms.  If there is no itching, it probable isn’t allergy.
  2. Colds last about a week. Viral cold symptoms peak around day three, begin to level off by day five, and then begin to resolve.  You may not be well by the seventh day but you should be significantly better compared to how you felt on day three.  A sinus infection is usually a viral cold that becomes complicated by a bacterial infection.  It begins like a cold but rather than getting better by day seven, things are getting worse with increased discharge, pain, and possible fever.  You should see a doctor if cold symptoms persist or worsen beyond the seven day mark.  The allergy timeline is much less predictable with allergy symptoms coming and going throughout the season.
  3. Everyone else is sick.  If everyone in your cubicle, classroom, or home has the same deep cough or sore throat, it is likely a cold.  During a rough allergy season, a lot of people may be sneezing at the same time, but those affected do not cluster in a family, school,  or work-place the way a communicable virus does.
  4. Olive trees in winter.   If you know what you are allergic to (Olive trees, for example) and you know when they pollinate (Olive tree in April), it is unlikely that your February and early March symptoms are caused by allergies (if Olive is the only thing your allergic too).

Arizona Winter Allergy Misery Mystery

Non-stop sneezing, horrible itchy eyes, wheezing and coughing,  all during the one time of year when allergies are supposed to be hibernating!  The bermuda grass is still dormant, the weeds are frozen from the recent frost, and the citrus and Olive trees will not start budding for several months.   What could possible be causing all this allergy misery in the middle of winter?

The answer is Juniper and Cedar pollen. Although a few ornamental varieties of these evergreen trees are found in yards around the valley, they are not as numerous as Mesquite, Palo Verde, Palm, or Acacia trees.   However,  at higher elevation, varieties of Juniper such as Oneseed Juniper (Juniperus monosperma) or  Alligator Juniper  (Juniperus deppeana) cover thousands of acres in every direction surrounding Phoenix.    When conditions are right, a cloud of Juniper pollen is carried by the winds down into valley where it becomes part of the brown haze hanging over the city.

So if you are sneezing and itching in January and February in Phoenix, and are wondering what’s going on, look to the hills.

Alligator Juniper

Alligator Juniper Payson, Arizona